PD 21:

ETHICS OF INTERVIEWING
&
COMMUNICATION ETHICS

Prepared by:
Assoc Prof Dr Eddie Soon,
Department of Psychiatry

QUEST INTERNATIONAL UNIVERSITY PERAK

COMMUNICATION

 theact or process of communicating;

fact of being communicated.
• the imparting or
interchange of
thoughts, opinions,
or information by
speech, writing, or
signs.
ETHICS
a system of moral principles

 dealswith values relating to human

conduct, with respect to the rightness
and wrongness of certain actions and
to the goodness and badness of the
motives and ends of such actions.
COMMUNICATION ETHICS
 The principles governing
communication, the right and wrong
aspects of it, the moral-immoral
dimensions relevant to interpersonal
communication are called the ethics of
interpersonal communication.
COMMUNICATION ETHICS
 Maintaining the correct balance
between the speaking and listening

 the legitimacy of fear and

emotional appeal

 degree of criticism and praise

COMMUNICATION ETHICS
A scarcity or overdose of either of the
factors could result in unfavorable
consequences.

 The principle of honesty on both sides

should be completely applied because
any amount of insincerity from either
the listener or the speaker would not
be prudent.
PRINCIPLES OF
INTERPERSONAL
COMMUNICATION
ETHICS
 Autonomy
Beneficence

PHYSICIAN

Do no harm
Justice
DOCTOR- PATIENT
RELATIONSHIP
 Do no harm. Hippocrates put this in words over
2,000 years ago, and it's still Rule Number One.
 Respect people as ends, not
means: consider and treat everyone as a
unique individual who matters, not using
them to achieve your agenda.
 Respect patients' ability to play a role in
determining what they need. Don't assume
that professional staff (and doctors) necessarily
know what's best for a community or individual.
 Respect everyone's human, civil, and legal
rights. This encompasses such issues as non-
discrimination and cultural sensitivity.
 Do what is best for patients under the
circumstances. You're not able to help
everyone all the time, but you can try to get as
close as possible.

 Don't abuse your position or exploit a

patient to gain a personal advantage or to
exercise power over another person - for
political, social, sexual, or financial gain.

 Don't attempt an intervention in areas in

which you're not trained and/or
competent. This goes along with "do no
harm," but it's not always possible
UNETHICAL COMMUNICATION
…threatens the quality of all
communication and
consequently the well-being of
individuals and the society.
ETHICAL REMINDERS IN
COMMUNICATION
 advocate truthfulness, accuracy,
honesty, and reason as essential to the
integrity of communication.
 endorse freedom of expression,
diversity of perspective, and tolerance
of dissent to achieve the informed and
responsible decision making
fundamental to a civil society.
 strive to understand and respect other
communicators before evaluating and
responding to their messages.
 ETHICAL REMINDERS IN
COMMUNICATION
 promote access to communication resources
to fulfill human potential and contribute to
the well-being of families, communities, and
society.
 promote communication climates of caring
and mutual understanding that respect the
unique needs and characteristics of
individual communicators.
 condemn communication that degrades
individuals and humanity through distortion,
intimidation, coercion, and violence, and
through the expression of intolerance and
ETHICAL REMINDERS IN
COMMUNICATION

 Being committed to the courageous

pursuit of fairness and justice.
 advocate sharing information,
opinions, and feelings when facing
significant choices while also
respecting privacy and confidentiality.
INTERPERSONAL
RESPONSIBILITY
 Involves:
a balance between distance and
closeness in each relationship, which
defines the quality of our interpersonal
lives (Stewart, 2006).
VIRTUE ETHICS
 concerned with moral character and
places more weight or value on the
dignity of an individual and a
humanity’s task of caring for one
another.
 It emphasizes character as opposed to
duty or consequence.
ETHICAL CONSIDERATIONS IN
INTERVIEWING

 Only what is clinically relevant

 No socialization, extra medical
communication
 Recognition of deviations
ETHICAL CHECKS AND
BALANCE:
Critically examine their own actions by
asking themselves the following
questions:

• Is this activity a normal, expected part of

practice for members of my profession?
• Might engaging in this activity compromise
my relationship with this patient?
• Is it acceptable with other patients? With
my colleagues? …with my institution? …with
the public?
• Could this activity cause others to
question my professional objectivity?
• Would I want my other patients, other
SITUATIONAL OR
CONTEXTUAL ETHICS
 There is no absolute approach to
situations, each situation should be
addressed as different from each
other.

 Every problem should be evaluated in

its particular context or situation.
 UNWHOLESOME
COMMUNICATION STYLES
Unwholesome communication Example
styles

Coercive Intimidation and threatening

others.

Destructive Backstabbing and inappropriate

jokes.

Deceptive Euphemism and lying.

Intrusive Eavesdropping, tapping

telephones or monitoring Internet
use
Secretive Hoarding information and cover-
ups

Manipulative-exploitative Acts which attempt

to gain compliance or control
through exploitation
ETHICS AND PROFESSIONALISM

Lying to patients
44 y/o woman has had 3 kidney
transplants. Recently HCV terminal liver
failure. Not candidate for fourth
transplant. Told that she is on the list -
alleviate anxiety

73 y/o woman has a malignant pleural

effusion. Patient wants to know. Family
does not allow data to get to patient.
Patient asks.
ETHICAL ISSUES ENCOUNTERED IN
CLINICAL PRACTICE
(WITH EXAMPLES)
CASE 1: REFUSAL OF
TREATMENT

 Chest physiotherapy is prescribed for an

elderly cancer patient by the attending
doctor, but he refuses. Must the
physiotherapist insist on carrying out the
treatment plan?
 Is it unethical to go against the patient’s wish
(to refuse)?
 CASE 2: DEMAND OF
ALTERNATIVE MEDICINE
 A 20 year old patient with severe head injury
from traffic accident did not improve with
rehabilitation.
 He cannot comprehend or communicate

 The mother demands the hospital to provide

hyperbaric oxgyen therapy (high pressure
oxygen treatment in a closed chamber)
 What is the extent of the mother’s right in this
case?
 How should the patient’s rights be addressed?
CASE 3: DEMAND OF MEDICAL
TREATMENT

 A patient with mental illness demanded to be

treated with the newest psychiatric drugs
 The doctor assessed and found that the
patient was not suffering from significant side
effect from the existing drug, which is also
one of the newer drugs that had passed the
patent period (cheap generic drug is locally
available)
 What is the extent of patient right in this
case?
 CASE 5: RIGHT TO DIE?
 A tetraplegic patient on chronic assisted
ventilation pleads for his right to die and to
legalize euthanasia. Does a patient have
‘right to die’?
In every situation be
ethical!